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Extracorporeal Radial Shockwave Therapy for Lateral Epicondylitis

Edson Antonio Serrano

Source: 16th International Congress of the International Society for Medical Shockwave Treatment, 2013


No re-occurence at 6-month follow-up


After 6 months of follow up, twenty-seven elbows (64.2%) were free of complaints.


Extracorporeal radial shockwave therapy has shown to be effective in the treatment of chronic tendinopathies of the elbow, shoulder and plantar fascia. This prospective case series study evaluates the efficacy of extracorporeal radial shockwave therapy in the treatment of chronic lateral


We conducted a prospective study in forty-two patients with lateral epicondylitis. Our patients were treated with three to five weekly applications of 6000 impulses of radial shock waves (BTL-5000 SWT, BTL-6000 SWT) with a progressive protocol. This protocol includes 2000 initial analgesic shockwaves followed by 2000 therapeutic shockwaves, and ending with 2000 of neurostimulation impulses. Analgesic or neurostimulation impulses are done with high frequencies of 12 – 18 pressure waves per second at a very low constant energy of 1.5 bar. Therapeutic levels are considered above 2 bar, and the frequency is managed from 12 to 6 impulses per second in a decreasing manner. Follow-up examinations were performed after one month, then every month up to 6 months using a pain visual analog scale from 0 to 10.


After 6 months of follow up, twenty-seven elbows (64.2%) were free of complaints, 10 (23.8%) were significantly better, 2 (4.7%) were slightly better, and 2 (4.7%) were unchanged. The only minor complication observed in the series was petechiae in 5 (11. 9%) patients.


This case series showed the benefits of radial shock waves using a progressive protocol that includes analgesic shockwaves before and after the therapeutic session, in the treatment of lateral epicondylitis.


Our protocols showed to be effective and safe in the treatment of lateral epicondylitis of the elbow with radial extracorporeal shockwaves. Case control studies are required to follow our results.

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